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When shortness of breath signals heart problems

Title: When Shortness of Breath Signals Heart Problems

Many different heart problems can lead to shortness of breath. It may happen suddenly or gradually over time. It may also occur only during physical activity or in stressful situations.

You should never ignore unexplained breathlessness, as it may be due to a serious underlying health condition. If you experience shortness of breath, please seek medical care.

Here at Metropolitan Cardiovascular Consultants, we partner with our patients to prevent and treat conditions and diseases that affect the heart while preserving and improving quality of life.

Dr. Djamson offers a wide range of cardiovascular services at our outpatient clinics. Patients can access advanced cardiac technology to diagnose and treat conditions that range from simple to complex.

If you have heart health concerns, a visit with a cardiologist is paramount. Symptoms of heart disease range widely, and a comprehensive evaluation is needed to identify and treat problems.

Unexplained shortness of breath may signal an underlying problem with the structure or function of your heart. Below is a list of potentially serious and frequently diagnosed heart conditions which may present with Shortness of Breath.

Coronary Artery Disease

Two main coronary arteries, the Left main and Right coronary arteries supply blood to the heart. These arteries may develop problems leading to serious and potentially life-threatening conditions

Coronary artery disease (CAD) is the most common type of heart disease in the US, it develops when there is a buildup of plaque in the walls of the coronary arteries leading to narrowing and eventually occlusion of these arteries.

These cholesterol rich fatty deposits (plaques) decrease blood flow to the heart muscle leading to a condition called Angina and raises the risk for a heart attack. Symptoms may not appear until there is a significant reduction of blood flow.

Shortness of breath, especially during exertion, may be an atypical presentation of Angina and may be due to underlying CAD.

Heart attack

A heart attack occurs when the heart muscle does not receive enough oxygenated blood and nutrients to function properly

Unfortunately, you might not have any symptoms of CAD until you suffer a heart attack. This makes it crucial to form a strong, collaborative relationship with your provider and schedule recommended checkups for prevention and early detection of heart disease. This is especially true if you have risk factors for CAD, these include Hypertension, Diabetes, High cholesterol, smoking and a family history of Coronary artery disease.

While chest pain is the most common symptom of a heart attack, patients especially women may present primarily with Shortness of breath and worsening fatigue.

You may notice a decrease in energy or breathlessness after minimal activity which you may attribute to ageing, a lack of physical activity or weight gain but these may represent early subtle signs of heart disease or a heart attack

Heart failure

Heart failure is a condition where the heart is unable to pump enough blood to satisfy the body’s need for blood, oxygen and other nutrients. This is caused by either diseased heart muscle which is too weak to pump enough blood to the body (heart failure with reduced ejection fraction) or a thick, stiff heart muscle which does not relax enough to be filled with blood (heart failure with preserved ejection fraction)

Shortness of breath is the most common symptom of heart failure. It is a distressing feeling that may cause you to feel smothered, Shortness of breath initially occurs with exertion but may get progressively worse and eventually occur at rest in severe cases. It typically is worse on lying flat on your back and patients sometimes wake up from sleep and sit up to catch their breath.

Causes of heart failure include CAD, long standing hypertension and a diseased Heart muscle termed Cardiomyopathy, this may be hereditary or may be secondary to diseases like Hypertension, CAD and sarcoidosis. A weakened heart muscle may also be caused by infections which directly damage the heart (myocarditis) most notably there have been multiple reports of Covid 19 causing myocarditis and eventually leading to cardiomyopathy and heart failure.

It is important that Heart failure is identified early and treated. Tests are available to help determine the cause of Heart Failure and treatments are available that have been shown to improve quality of life, reduce hospitalizations and death from heart failure

Cardiac arrhythmia

Heart rhythm abnormalities, conditions in which your heart either beats irregularly, out of step, too fast or too slow may present with shortness of breath, these conditions are usually easily identified and can be successfully treated and in some cases cured leading to a complete resolution of symptoms,

Your provider may first notice an arrhythmia during a routine physical exam. An arrhythmia may signal a harmless condition or something more serious. Common symptoms such as shortness of breath and dizziness require careful evaluation by a specialist.
Valvular Heart Disease
Heart valves work normally to perform 2 tasks 1. Open wide to let blood flow through 2.Keep blood flowing in one direction and preventing blood from leaking back in the opposite direction.
Conditions in which the heart valves do not open all the way lead to a narrowing of the valvular opening termed Stenosis if this is severe it may cause shortness of breath either due to the valve disease itself or because it leads to a cardiomyopathy and lung disease. When a valve is diseased and does not shut completely it allows blood to leak backwards this is termed regurgitation and when severe enough may also lead to shortness of breath. Valvular heart disease is easily diagnosed with a thorough physical exam and tests such as an Echocardiogram. Treatment of heart valve disease is more successful if instituted early, before patients develop cardiomyopathy and other irreversible effects of valvular heart disease like lung disease


The pericardium has two thin layers of tissue that surround the heart, and inflammation of the tissue is called pericarditis. If you have pericarditis, you may experience chest pain and shortness of breath. Viral infections and autoimmune disorders can cause pericarditis.

Pericarditis typically resolves on its own, but may be severe or become chronic, it is important to identify and treat the underlying cause.

To learn more about how you can keep your heart healthy, please reach out to us by phone or request an appointment online at one of our three locations in Beltsville, Bowie, and Columbia, Maryland. You can also send a message to Dr. Djamson and his team

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